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Diagnosis Rectal Cancer (MRI Pelvis, CT abdomen, CEA,MMRI/MSI…

- - - - Surgery ( TEM or TME)
        
        Observation
- - - - Chemo (capecitabine+ radio)
        
        Clinical response ?
        
        No
        
        Surgery
        
        Yes
        
        Wait and watch
- - - - Surgery
        
        Adjuvant chemo
- - - - RAS wild tye folfiri/folfox + EGFR I
      - RAS mutant : folfori /folfox +VEGF I
      - BRAF mutant : encorafenib
      - HER2: trastuzumab + pertizuman
      - DMMR: pembrolixuzumab
    - - Surgery
        
        Post op chemo